Five month old development concerns- help please!

[bbb2019]

Hello! Looking for some advice and guidance

I have a five month old son- he’s lovely. However, I am concerned about his arms. Most of the time they hang by the side of his body (if he’s sitting or being held as an example). He’s also showing a preference for his left hand- when sitting in a chair or bouncer he will use his left and have the right outstretched almost leaning on it.

My other concern is that he doesn’t reach or bat for things- rarely have I seen him reach for an object on his play gym for example or swipe at it at all. He has used his left arm to try and grasp the object but is less controlled with his right.

He’s able to pick up objects with either hand, being them to midline and to his mouth. Able to grasp with both. Right hand is more in a first than the other but this isn’t how it is all the time.

I’m just concerned I feel like every other baby is reaching and interested in toys etc and he’s just not. He’s able to roll from back to front in one direction (left hand side) and can prop himself up but likes to put his arms out and shuffle his legs up. Can bear some weight on legs for a short period. Doesn’t reach out for anything when supporting sitting just stares.

Can track toys. He has an eyelid issue. No visual concerns- this has been monitored by hospital.

Eats well and is in the 93rd centile.

I’m quite anxious so advise and suggestions would be welcome. Obviously dr google hasn’t helped at all.

[BillHadersNewWife]

How was his birth? Straightforward?

[bbb2019]

No, 3.5 day labour & forceps used.

[BillHadersNewWife]

To be honest, I've just looked at what's expected between 4 and 7 months and he is hitting his milestones OP.

roll over
bear weight on legs
sit while supported
reach for objects

These are what they're meant to be able to do...perhaps you're overly worried or focusing too much on his arms due to some anxiety?

But it sounds fine to me...low muscle tone or Hypotonia can cause some issues with limbs but it doesn't sound like he has that as he's able to roll over etc.

[surreygirl1987]

My son had an arm preference too. He had torticollis, caused by an aggressive ventouse delivery. With lots of exercises and working with a physio he got entirely better within months. He was also assessed by a neurologist to make sure there was no lasting damage but she said he was absolutely fine. He's perfect now and you would never know. With your child it might be absolutely nothing. However, arm preferences are always worth getting advice over. Can you take him to a HV and ask for a referral to a physio? That's what I did and he was given an appointment for an assessment within a week!

[bbb2019]

I had wondered about that Surrey girl as when he sits he leans to the right with his head (the arm he doesn’t use as much). I know he can use it (I’ve seen him) it’s just clearly not as comfortable or as able. I have a go appointment tomorrow so will raise it then. I’m not a massive fan of my hv..!

[BillHadersNewWife]

Is his eyelid issue Ptosis? There's a link with Torticollis and Ptosis.

[bbb2019]

Hey, yes it is. It’s in the left eye though.

[BillHadersNewWife]

Definitely see the doctor and mention Torticollis. Hope you get some answers.

[sea22]

How is the movement in his left eye? My daughter has Duane's syndrome which means she cannot turn her left eye outward - one of the things I noticed was that she had a preference for activities only on her right side too!

[surreygirl1987]

Ah my son had the head tilt too, especially when sitting. In fact, we noticed that before we noticed the arm preference. Definitely worth getting an assessment done - even if it's not torticollis it could be something similar and easy to sort out, yet detrimental if left. Just to warn you, both our GP and midwife dismissed it at first and said head turning preference (the first thing we noticed) was normal (!) and it was only when I went to a children's centre (sadly now closed) in tears that a nurse st the health clinic there referred him to the local physio... so be prepared to stand your ground and fight for physio assessment if need be. An arm preference should be enough for that anyway though- it's on the Ages and Stages Questionnaires so they should take that seriously. Good luck.

[bbb2019]

Thanks. The more I think about it the more this makes sense. He can keep his head midline but absolutely prefers to look to the left. I know he can use his right arm but when sitting for example the high chair he will lean to the right and then use it to prop leaving his left hand free. I went to the gp yesterday and she said she’s confident there’s nothing significant wrong as he wouldn’t be using it at all or have any reflexes which he does have. I guess for now I’ll keep doing some head stretches and encouraging him to use his right arm. She’s done a referral to a speckalist too. I did mention it to a hv yesterday and they said he’s still so little he probs is just working things out. I’m not so sure based on what you’ve said so I will mention when I get him weighed next as I think physio might be the answer. Guess it makes sense with his Ptosis too. Can you remember anything you did Surrey girl that I could perhaps use?

Sea22 thanks for the advice. His eyes are ok- they’ve been checked twice by specialists and no evidence of any issues (that you can tell with a four month old anyway).

[surreygirl1987]

That sounds a lot like my son. He preferred looking to his right (my left). It CAN improve on its own, but usually needs some minor intervention (stretches etc). Yes, sounds like a referral to the physio is in order.

Things that helped...

• restraining his 'good' arm thereby forcing him to use his weaker arm. Sounds cruel but was probably the most effective thing we did. Too young to throw tantrums yet, my son didn't seem to mind it too much, and willingly used his weaker arm more when he had no choice. Th is strengthened it very quickly and made him realise he could use it!
• lots and lots of tummy time. My son could only prop himself up and one arm and reach with the other, so again we restrained his good arm. Takes a lot of effort but so worth it.
• if head tilt, a stretch where you hold baby facing outwards in one arm, forcing tilt to go the other way. If you think that might be useful I can show you a pic.
• physio suggested tummy time on exercise ball but we didn't get on with that so well.
• he always had his head rotated the same way while sleeping, so I used to sneak into his room at night any gently rotate it the other way. Hated doing that. Thankfully he was a good sleeper and rarely woke!
• he got a flat part of his head, plagiocephaly, due to head turning preference. Worth looking out for.
• putting toys and anything interesting only in reach of his weaker side/arm.
• if you Google NHS torticollis stretches you will come up with more, but best done after checking with physio I guess.

Hope that helps and good luck!! Any more questions let me know- more than happy to help where possible.

[bbb2019]

Amazing! Thank you!

[Jpan]

@bbb2019 - would you please update regarding your little one? X

[bbb2019]

Yep! He’s 3 now and fine. He has Ptosis in his left eye but this has improved with age & doesn’t impact vision.

He did have toticollis- they think because he was pulled out via forceps it damaged his neck and explained the hand preference. as soon as he crawled things got better. The physio we had said this was the best therapy. Uses both hands equally well
now & I’m not really sure what his preference is yet.

hope you’re ok & that helps x